tv Taiwan Outlook PBS August 22, 2013 11:00am-12:01pm PDT
cause of death in taiwan for many years as well as worldwide during -- what. our guest is the ceo of the formosa cancer foundation to find ways to prevent this deadly disease. welcome to the program. >> hi, everybody. i am a medical oncologist and the ceo for formosa. >> if i may start out the program by asking you, can you give us a brief background about the formosa cancer foundation? >> sure. formosa cancer foundation was established in 1997. the major purpose for this foundation is trying to set up a program, a public education program, by using the health, lifestyle and more vegetables
and fruit to reduce the cancer incidence and mortality. >> what are the major foot -- the major activities and functions of the foundation? you mentioned education. do you cut out courses or promotional videotapes for people to get a better understanding for ways to have a healthy diet and therefore a healthy lifestyle? >> the major thing for the education is teach the people that cancer is a preventable disease and that we focus on the family. so we educate the mother first. in the beginning, we are training 4000 mothers. and then we found the children
play a major role in the family. we asked the mother to prepare more vegetables and fruit -- for the parents, especially the father -- and we asked for the mother, especially the father, and we started program in the elementary school. also, we are training the new dietitians in the school. and the training of the teacher and we set up all the teaching materials. so we have brochures and some activity training. so the dietitian plays a very important position in the school. there is intervention activity in cooperation with the university in the agriculture.
because they have landed the oath of its a lot of vegetables and fruits. it is interesting for the kids. so this program started to recruit kindergarten kids and then the him into school. sometimes we extend through junior high school. a weekly activity. on the weekend, a lot of children go visit and learn and touch the fruit and vegetables. i think that is very important. it is fundamental work for education. >> i think most of the viewers will educate -- will agree with you that education is very important on the prevention of cancer. let's get back to the disease itself. cancer has been a leading cause
of death in taiwan over 30 years. has that situation remained the same or has it deteriorated in recent years? >> unfortunately, the cancer incidence is increasing in the past decade. even the mortality has slowed down, but the incidence -- i will show you some of the data. 2006 to 2010, you can see the new cancer cases increasing. on average about 5% per year. for one new case, every seven minutes and 10 seconds. now it is every five minutes and 48 seconds.
it is increasing. also, when you look at the age- adjusted instance race, you can see the increase in the female breast as the most astonished. and the second is colorado -- is colorectal cancer. when you get the cancer and lung cancer, those have on down. that is good news. but aging people, like a cancer is increasing and the oral cavity cancer is also increasing. in females, endometrial cancer is increasing.
this is more detail of the numbers. these are the top 10 of all cancers, two thousand nine and 2010. so you can see the number now is more than -- 2009 to 2010. so you can see the number now is more than -- is increasing. this is the top 10 male. you can see prostate. these are the three most striking cancer in the male. in the female, it is breast and
colorado and -- and coloratura and -- colorectal and uterine. the mortality rate has remained the same or a little bit decreased. that is good news. however, in contrast in both male and female, it is increasing. this is taiwan compared to other countries. this is the incidence rate in the mortality rate. in several countries, they do oecd. taiwan is in the upper middle. of all the european countries, they are higher than taiwan. but taiwan is one of the most high incidence and high mortality in asia.
>> all right. that is an alarming chart. given the developments in recent years, you have been monitoring the disease for 20-30 years. what do you think the reason since is that cancer has been going up in taiwan primarily? is it because of lifestyle or dietary habits? what are some of the leading causes? >> why cancer for the past 30 years as the number one cause of death in taiwan, i think just because other cause of death decreased, like infection, pneumonia, disease. all of the mortality reduced due to the improvement of our healthcare.
but this only plays a minimal role. the major role why cancer remains number one is because, in the past 30 years, it changed . more western-style. in the female, breast, uterus, the ovary and the colorectal. they all belong to high intake of high calorie diets, red meat or less vegetables, fruit and fiber. i think -- i have seen the major change in the past 30 years because we have changed more in lifestyle. >> has the incidence in cancer increased in young people?
for example, 40 and under, what is the situation in taiwan? >> i think it is universally the same. in the modern country, more and more young people eat high calorie fast food and they don't like vegetables and fruit. in taiwan, we seem, that we see, for example, bavarian cancer. -- over. in cancer. -- ovarian cancer. now we see many more beautiful ladies age 32 or less with cancer. they're becoming oyoung. we can see also breast cancer
has been increasing but the mortality rate has pretty much stayed austerity -- stayed steady, even decreasing. >> i think the taiwan government has started cancer screening for the whole population 5-6 years ago. now the cancer stage is earlier and earlier. so that is one of the reasons why the mortality rate, because the year-earlier detection and treatment, we can cure those people. so that is why the mortality decreased urine -- decrease. the second, the treatment is more modern and therapy can be
very effective to treat the disease even cure the patient. so that is one of the improvements over the treatments that we can offer to the patient's. -- to the patients. people not knowing prevention of cancer by the diet control. people with cancer now know that they can prevent the recurrence and will affect the mortality. we can prolong their lives. i think those are the major three reasons. >> one of the key reasons that you mentioned earlier regarding
the cancer prevention is to educate and. and your foundation -- is through gende education. it is important that we get important personalities and corporations involved in the process. for example, in taiwan, some corporations seven sponsoring prescreening of cancer diseases for women at the early stage. that has been very effective and has done very well for the corporate image of the company. but in recent weeks, we have seen a very publicized case involving the hollywood actress ms. angelina jolie who has been detected with the high risk of contracting breast cancer. and she took the preventive medical procedure of taking out
both her dress as a precautionary measure. can you tell us your expert to you on this particular case? >> as we know, the tendency of breast cancer, the major cause is the gene mutation. it is caused at an earlier stage for families who have the breast cancer. angelina jolie, i think is one of them. her mother, her aunt, the mother's sister, they both had breast cancer and she followed some of the guidelines. she had to take the genetic
testing at an earlier stage. and she found that she had the mutation, the gene. in this case, the prophylaxis preventive mastectomy. we need to ask whether the government supports such an operation in taiwan. it is very expensive. it costs about $160,000 taiwan yen. also, in taiwan, the incident of breast cancer accounts for 5% of the whole breast cancer. so is it appropriate to the government to cover all the
genetic testing? i think there are some limitations so we have to identify the high-risk families, the high-risk person and then ask them to do such testing in taiwan. and it is now available by some companies. >> of course, angelina jolie's case will serve as a very important warning to a lot of people who identify in the high risk group. you mentioned if your relatives, mothers, fathers, if they have had the disease, you may be in the same category. we understand that education probably sometimes is not enough. it is adequate but not sufficient. in addition to education, what else can we do to take care of cancer patients?
for example, other programs that are available at the formosa cancer foundation, are they involving caring for the patients and their families? >> i can answer your first question. i think the government in taiwan , they start a whole general population screening, ike the pap smear for the cervical cancer, and for the colon cancer and also the mammograms for the breast cancer. but like you say, it is not enough. it will identify some genetic tendencies, jeans with a predisposition and those high- risk people. i think the government has to pay attention more on that population, even if small.
colorectal cancer, some have a genetic predisposition. it is the narrow one in incidence. i think we have to take into account the genetic cases for families with colon cancer. >> regarding caring for the potential patients? >> we reduce the mortality. one of the major reasons is that the cancer patient recurs less and less. so how to take care of them and educate them and changing their living style and bad habits is very important. that is why we started the education service, cancer survival care and cancer education center.
this one in taipei last year in gaucho -- it is free. so we teach them how to cook, how to make festivals and fruit and more appropriate for everybody. we set up the program with exercise program, relaxation program, even how to make them more beautiful, make up. the group city for those cancer survivors is also -- the group's eddie for those cancer survivors is also very important. >> let's talk a little bit about the international dimension for the foundation. we understand that there is
union for international cancer prevention, uicc. your foundation has been a member since 1997. 2003, i'm sorry. given the fact that you have been part of this international family, what are some of the activities and programs that you have been doing on the international level? >> uicc is now the biggest ngo under the world health organization. we are fortunate to become one of the members in 2003. we actively participate in all the activities. the biannual world cancer congress and also the highly publicized activities every year.
>> before we end this part of the program, we understand that your foundation has an ongoing cooperation with the agriculture department division of the american institute in taiwan. can you tell us a little bit about that program? >> we are so fortunate. the ait people can visit us. they want a cancer revision -- a cancer prevention program for the kids. they publish books for kids, training the nutritional needs in school, and they help us to
prepare the festival check. it is a very successful program. >> how does that work, the vegetable checks? >> you can sign -- we mentioned how to eat or how to prepare -- you finish and then you say yes. then the mother or the father will sign it and then you can feel the soft. -- you can peel this off. you can send the check to the formosa cancer foundation and they can get their flight tickets to japan or the united states to join the -- nine >> another gathering of entering --
on the prevention of cancer. we understand that relations have been through a lot of progress since the president was elected in 2008. have there been cooperative programs between the formosa found -- formosa cancer candidate in and other parts in china? >> i think the answer is yes. because the government in china focuses on the future of the kids, they pay a lot of attention on the health of the kids. especially the cancer program. so they asked for our collaboration. next month, we are going to
beijing. we set up through the media and the training program to take this opportunity to allow the people in china the awareness, the public awareness, and we are training dietitians had to set up the program like we did in the past five years in taiwan. >> given the fact that china is so much bigger than us, they also must have a serious concern over the spread of cancer. how is the situation in china different from the situation in taiwan? or are they very similar? for example, incidence of rest cancer for women and prostate cancer for men, are they any much the same? >> the development of the country is a major impact for
what kind of cancer becomes the more popular. because of the modern style of the food, breast cancer and: cancer are now rising. -- and colon cancer are now rising. so the prevention is universally the same. you can cut down the colon, breast, prostate goo. the program will be the same. >> this is a wonderful onset, especially for younger children. we understand come in addition
to this, you have also come out with some very effective slogans for the government as well as for the people in taiwan. on the ways it they can prevent spread of cancer, including eating at least five festivals and fruits a day -- five vegetables and fruits a day, along with quitting smoking and having more exercise and things. can you tell us a little bit about that particular campaign? >> the first campaignrted around year 2000. it is similar to the united states. they asked the people to have five servings of vegetables and fruit a day. five years later, we saw it was
not enough because we hope the people can eat more to cut down not only the cancer incidence but also died-related disease like obesity, diabetes, and hypoglycemia and cardiovascular disease or stroke. but in the recent few years, we find that this is not enough. so in conjunction with the government, we combined the programs. we combine the five tips. wine is more -- one is more vegetables and fruit and regular exercise. the periodic cancer screening
and the reduced body weight to reduce obesity and the most important is tobacco control. we hope all the people in taiwan can cut down the smoking rate and prevent excess smoking. >> we understand another role that the formosa cancer foundation has played is the role of advocacy. advocacy in support of certain government policy. for the last few years, we believe that the cancer foundation has been in show mental in the passage -- has been instrumental in the passage of the tobacco prevention act. can you tell us about some of the activities the foundation is doing to raise government awareness and get more government resources on the particular policy? >> the health promotion department in the doh, the
department of health, is working very well. we have lots of dialogue with them. they also asked us to promote cancer screening. for example, cervical cancer, the pap smear, we've set up a roundtable discussion to invite the experts on some special issue for the young, schoolgirls for my evening junior high school -- even in junior high school or they can start the
program for kids to prevent cervical cancer. so we set up such dialogue and communicatin and meetings and even public education programs. now the government, the bureau of health promotion, we are working together. >> we understand that, since the founding of the foundation, the foundation certainly has done a lot of cancer prevention education and the caring of the cancer patient and their families. given the fact that the foundation has done so much over the years, we also understand that the foundation under your leadership has been recognized for many of the compass meant that the foundation has achieved. -- many of the accomplishments that the foundation has achieved. can you share some of them with us? >> during the cooperation, the
three-year program, they recognized our efforts. we were honored to receive the distinguished international service award from the department of education in the united states in 2008. we also are honored with the highest level of the civic award in 2007 to recognize our important service. >> given the fact that the foundation has done so much and cancer prevention a has become a general concern for the people of taiwan, what is some of the things that the foundation plans to do more in the coming years?
for example, may be more emphasis on education or is it more emphasis on the caring of the cancer patients and their families? has the foundation set a direction for the next few years? >> once the prevention concept becomes common sense in the community or the family, the most important for our foundation is how to care, how to prolong the life of cancer survivors. how to include them in education and activity. we set up the cancer survivor and service center. they now regard the formosa cancer foundation cancer
survivor center as a second home. in the past, the cancer survivor isolated themselves in the family. they feared to go out. >> they feel like society has forgotten about them. >> so we have the cancer service centers. >> that is terrific. we need to take the final break on our program. we'll be right back.
of formosa cancer foundation. we have been talking about education as such a key part of cancer prevention. but in the process of educating the public to get to know the disease better, there are also some preconceived misconceptions about the disease. what are some of the misconceptions that people have about cancer? >> you know, a lot of cancer patients, when they were diagnosed, they are scared. they fear facing the disease because of the disease being a fatal disease. he improvement of
the technique and treatment, now more and more cancer patients survive. by estimation, in taiwan now, we have cancer survival more than 400,000. >> that's wonderful. >> i think the misconception today is that cancer is a prevention -- a preventable disease. it can be cured if we treated properly and earlier. >> what are some of the programs at the foundation has available in terms of trying to correct those misconceptions? would that be part of the overall educationrogram? >> the first slogan of the
formosa cancer foundation is not five a day. actually, we say that cancer is a preventable disease. it can be cured. so don't worry. >> it certainly gives people a boost in their morale and spirit as they continue to fight this deadly disease. >> and following our prevention program. in the beginning, we did a lot to correct this misconception. >> looking at in this situation taiwan, socioeconomically, we al see that we have the problem of the aging population. this is not unique to taiwan. the same thing is happening in japan, for example, maybe to a lesser extent in china.
given the fact that with the aging population, does that necessarily mean that the incidence of cancer will be increasing because of the aging population? are we now detecting the similarities or differences between the low-income, middle- income, and high-income groups in the population? >> the answer is yes. the higher the age of the population, the more the incidence of cancer. so the government has to pay more and more money for early detection among the aging people. that through the public education, we can ask the aging population how to change their diets, how to eat more vegetables and fruit to prevent or improve their health.
very common, even in china. stomach cancer and esophageal cancer, i think the low-income still remains a high incidence in those cancers. lung cancer is still very high. there are a lot of people in china smoking. so we see that in the line middle-income entries. but higher income countries, because they can't afford --
because they can afford better food and red meat, the colon cancer is very popular in taiwan. i think that is universal. >> for the final part of the program, we will get upfront and personal with you. looking at your your career, you certainly had a very distinguished career in the prevention, in the studying and researching and treatment of the disease cancer. and you are one of the founding members for the formosa cancer foundation. over the last 2-3 decades, what does the foundation mean to you in terms of being such an integral part of the foundation? >> as a medical oncologist, in past decades, i saw lots of incurable cancer patients come
in to my clinic. finally they pass away very quickly. and then i asked myself, in addition to my service and research careers, what can i do for the patient and the family? some business want to donate -- his wife passed very quickly within three months. so he wants to help the the people. so that is why we have set up 15 years ago. for me, i think, the prevention through public education is the most important. we are so happy that the government adopted our concept of education policy in taiwan.
but i think we want to do more with collaboration internationally with the united states and china, japan and also i think the more and more fundamental research for cancer prevention should be focused. probably in the next few years, we will generate some donations to the research unit to find out the active ingredient in food, like comestibles, that can help in cancer prevention. probably the next decade, we don't need to eat more vegetable and fruit and just take a pill. [laughter] >> that certainly would fit the lifestyle of today's youth. there must have been moments,
for example, you were of course frustrated that some of the cancer patients are not able to be cured. but on the other hand, there must have been moments you were very excited to some of the nations come after being cured by you and your colleagues, have been able to recover from the disease, cured the disease. can you share with us some of those more happy moments? >> in the beginning, i had patients who were in stage three or stage four. through the efforts of modern treatment, some very experimental treatment, they adopted more and more fruit and even taking some herbal medicine.
they combined altogether. the most important thing i learned from that is that they relaxed themselves. they are more happy. they spend a lot of time to help people. so they have become our volunteers. then they can educate the other survivors. they are role models. the formosa cancer foundation creates a platform for cancer survivors. the training group and education is the most important. >> it has been a pleasure to have you here in the program. i want to wish you and the